I Don’t Want to Do Anything – What’s Wrong with Me?

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By Marie Miguel

There are times in our lives when we feel down, and we can’t figure out what the source of the problem is. There’s a difference between feeling sad and being depressed. When you don’t want to do anything – not even simple things that you enjoy – there’s a problem. When you find yourself with no motivation, it’s time to seek help because you may be depressed. When you’re thinking “I don’t want to do anything,” there’s something inside of you that’s telling you that life isn’t worth enjoying or pursuing, and that’s not true. You have individual interests and motivation, and there’s inside you. You have things that make you happy, but you can’t see them at the moment. That’s the problem; when you feel stagnant and lack positive emotion. It’s a symptom that shouldn’t be ignored, and it’s important to know that you can get through this time.

Pushing past the “I don’t want to do anything” feeling

One way to push past this feeling is to pursue therapy, but getting to that point is difficult because your brain is telling you that there’s no point in doing anything; including going to therapy. It’s essential that you work past those feelings of stagnancy. It’s vital to remember that what your brain is telling you isn’t true; there is a point to live, and you do have things that you enjoy. It’s about pushing through and remembering that the thoughts going through your mind are attributed to depression; they aren’t a reflection of who you are as a person.

Depression lies

Depression isn’t who you are. Depression is a mental illness that has symptoms such as lacking motivation, sleeping too much or not sleeping enough, changes in appetite, thoughts of emptiness or hopelessness, and thoughts of suicide or a plan to end one’s life. If you’re having thoughts of suicide, please call 911 or go to the emergency room. Contact a mental health professional and get medical attention immediately. Depression is a legitimate illness, and it needs to be addressed. If you’re feeling an emptiness inside, it could be because of this mental illness. It is treatable, it isn’t your fault, and there’s nothing wrong with you.

There is nothing wrong with you

Hear this now: there is nothing wrong with you. If you have depression, you are not alone. You’re struggling with a medical condition that many people, in fact, millions of people in the US alone, battle every single day. If you look at it that way, you’ll be more apt to seek help. It’s okay to acknowledge that you feel hopeless, as long as you pursue something that’ll help you move past this feeling. You’ve got this. Things will not be this way forever, and you will be able to move forward, no matter how hard it seems. Remember a time when you felt emptiness or sadness and were able to push past it and keep going. If you’re reading this article, you are alive. If you’re reading these words, you are strong, and you deserve to seek help.

Online counseling

Online counseling is an excellent place to seek help for feelings of emptiness and that “I don’t want to do anything” feeling. You are allowed to feel lost, but your online counselor is there to help you push through these feelings and find a way to cope. You might feel helpless, but your online counselor believes in you. Don’t be afraid to reach out for help.

This is a featured post by site sponsor Better Help.


10 Common Signs And Symptoms Of Depression—And When To Get Help

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By Hallie Gould

According to the National Alliance on Mental Illness, approximately 18.5% of adults in the United States experience mental illness every year. That’s a significant portion of our population—one in five people—yet the stigma and misunderstanding that surround mental health remain. If you are feeling symptoms of depression, talk to your doctor to learn more about treatment options.





We throw around the phrase “I’m depressed” to describe a stressful situation at work or the end of a relationship. But just like the word “crazy,” for which the etymology has shifted over time, depression can often be mistaken for a way to characterize an emotion rather than a mental health issue. It trivializes those who suffer from the disorder, a real chemical imbalance that creates negative and difficult circumstances beyond our control.

Because it all can seem convoluted, the definitions melting into each other, it’s often challenging to know when to seek help. “Treatment should be sought for depression when the symptoms are interfering with the quality of your life,” says therapist and mental health expert Scott Dehorty, LCSW-C. “Depression is treatable, and there is no reason to suffer in silence.”

To get a better understanding of the hallmark symptoms of depression, I reached out to two experts for their opinions and advice. Below, they detail 10 different, common warning signs to look out for. Keep reading for their thoughts.

Next Steps: 

“Any of these symptoms can occur with any of us at any given time, and that can be completely normal,” notes Lindsay Henderson, Psy.D., a psychologist who treats patients virtually via the telehealth app LiveHealth Online. “But if you are experiencing more and more of these symptoms, or they are growing in severity, start paying a bit more attention to how you are feeling overall. If you notice that these symptoms are impacting your overall functioning, it may be time to seek professional help. The good news is that help can come in many forms and individuals have options for how they address their mental health.”

We know that things like social activity, healthy eating, good sleep, and regular exercise all directly contribute to a healthier mood. If you notice yourself experiencing symptoms of depression, take a look at your daily routines and overall physical health to identify areas that can improve. “It can be beneficial to engage in therapy and talk with a mental health professional about what you are experiencing,” says Henderson. “Not only can a therapist help assess and diagnose the experiences you may be having, but they can also offer tips and tools to better understand, manage, and cope with the many complex emotions you feel.”

Here’s the thing: We know the idea of finding a therapist and getting to appointments can be overwhelming. Online therapy can be a wonderful way to break down many of the barriers that can get in the way of accessing therapy, as the appointment can take place wherever you feel most comfortable. Talk to your doctor to make the best plan for you and seek out an appointment with a psychiatrist. Your doctor may talk with you about the pros and cons of taking medication, which can be particularly helpful with depression and anxiety, but not for everyone. It’s best to talk first with a professional about your options before making any decisions.

Diabetes and Depression: Which Comes First?

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By Chris Palmer

Diabetes is now an epidemic in the United States. About one-third of the US population has either diabetes or pre-diabetes! It is well established that people who have diabetes are at much higher risk of developing clinical depression– about double the risk of people who don’t have diabetes. What is much less appreciated is that people who start off with depression, with normal blood sugars at the time, are at much higher risk of developing diabetes in the future – the rates are about 60% higher than in people without depression. Why do these disorders go together so frequently? Is it more than just a coincidence?

First of all, let’s define what we mean by “depression.” We’re not talking about simply feeling bad or tired for a few days.  We’re talking about major depressive disorder, or clinical depression – the illness that leaves people feeling depressed or sad most days, that robs them of almost all joy and pleasure in life, that disrupts their sleep, leaves them feeling tired and exhausted, interferes with their ability to work or concentrate, and might even have them contemplating suicide as a way to end their suffering.  Clinical depression is all too common, and is now the leading cause of disability in the world!

One of the most popular theories about why people with diabetes have higher rates of depression is that it’s difficult to have diabetes, and maybe the stress of having a chronic illness, with worries about blood sugar levels, diet, and taking pills or insulin injections would leave anyone feeling down, if not downright depressed. Given that diabetes most commonly occurs in those who are overweight or obese, another theory is that our society’s biasagainst heavy people might take a toll on self-image, and might make getting a job or dating more difficult, which could leave people feeling depressed. While both of these theories may, in fact, play a role in causing clinical depression, it appears that there is much more to this connection than simply stress, society, and psychology.

Inflammation is found in both disorders. In fact, inflammation in the bloodstream has been found in many chronic disorders, including both diabetes and clinical depression. No one knows for sure what is causing this inflammation, and we don’t yet know if it is causing these disorders, or simply a consequence of these disorders.  In other words, it’s possible that inflammation causes both depression and diabetes, or having diabetes or depression causes the inflammation.  Clearly, there’s more to the story than just inflammation – otherwise, everyone with it would develop both diabetes and depression.  However, if inflammation is a risk factor for both disorders, it’s not at all surprising that these disorders go together, and this would point to a biological reason for the overlap in disorders, as opposed to simply a psychological reaction to being overweight or having diabetes.

Cortisol is another factor. We know that cortisol is often elevated in people with depression, and we also know that cortisol worsens blood sugar levels and insulin resistance, so this may also be a factor in how depression can make diabetes more difficult to control.

Does the overlap of these disorders really matter?

Unfortunately, all too often, medical professionals assume that it doesn’t – they assume that people simply have two different disorders that really have nothing to do with each other. In reality, people who have diabetes are not only twice as likely to develop depression, but when they do, on average, it lasts 4 times longer than in people without diabetes – 92 weeks vs 22 weeks.  That’s almost two years of suffering from depression, even when getting treatment!  Likewise, depression can affect diabetes.  When depression occurs in people with diabetes, their blood sugar control gets much worse – they tend to have higher blood glucose readings, worse insulin resistance, and higher rates of diabetes complications, such as blood vessel damage. Some people assume that this is because people who are depressed might eat more junk food to comfort themselves, or may not have enough energy to take care of themselves.  While these might be true, it’s also possible that the inflammation from having clinical depression also worsens their diabetes, and that it’s truly a physical thing, not a mental thing or a matter of willpower.

What to do?

1.       If you have diabetes, be aware that you are at higher risk for developing clinical depression, and seek help if you notice these symptoms.  All too often, people ignore them, and assume they are just getting older and running out of steam.  Your primary care doctor can help assess if you have clinical depression, and can likely start appropriate treatment.

2.       If you have clinical depression, know that you are at risk for developing diabetes, which could make your depression even worse. Routine screening of your blood sugars can be helpful. If you have depression that is not getting better with current treatments, you should get checked for diabetes to see if this might be contributing to your poor response to treatment.

3.       Consider a change in diet.  There is some evidence that the Mediterranean diet can help improve both diabetes and mood, even in people with chronic depression. The Mediterranean diet emphasizes more whole foods and eliminates processed foods and junk food, which may be enough of a dietary change for some people. Alternatively, diets low in carbohydrate and higher in fat, such as the ketogenic diet, have shown more dramatic results, even reversing diabetes in a study of over 300 diabetics, and this can help improve mood and energy as well. If you have diabetes, however, you should consult your doctor before trying a ketogenic diet, as your medications and/or insulin will need to be reduced rapidly due to the powerful effects of this diet.

4.       Exercise! There is abundant evidence that exercise can help both diabetes and depression. It’s a new year, so if you haven’t already started a new year’s exercise routine, time to start now. You don’t need to start at a gym if that makes you uncomfortable – you can start with short walks and work your way up to longer walks and short jogs along the way. If your knees can’t handle that, think about swimming, cycling, yoga, or a myriad of other ways to move your body and get your blood flowing. If you have severe diabetes and haven’t exercised in years, talk to your doctor first about starting safely.

India’s Suicide Capital: Sikkim

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By Diwash Gahatraj

Despite a booming economy, Sikkim has the highest suicide rate among all Indian states, second only to the Union Territory of Puducherry.

Gangtok: For Sukhrani Limbu of Sordung village, about 120 km from Gangtok, 29 May 2016, was just another usual day at work. But upon her return home, she found her eldest son, 30-year-old Aitey Singh Limbu, hanging from the ventilation shaft in his room.

Life somehow went on for the grieving mother. But then came 29 May 2018, when her third son, 27-year-old Aitey Hang Limbu, hanged himself from the same ventilation shaft in the same room.

“There was no suicide note, no signs of sickness… I am still clueless about what triggered their suicides,” Sukhrani says, fighting back the tears.

Sukhrani is not the only mother or family member in Sikkim who’s searching for answers. A National Crime Records Bureau study reported that the landlocked Himalayan state witnessed 241 suicides in 2015, 2.1 per cent of all the suicides in India that year.

But in terms of suicide rate in the last decade, Sikkim has the highest (37.5) among all states, and the second highest in the country after the Union Territory of Puducherry (43.2). Suicide rate is the number of suicides per one lakh population. According to the 2011 Census, Sikkim’s population was 610,577.

The West district, where Sukhrani lives, is Sikkim’s worst-affected region. Between 2008 and 2018, 278 cases of suicide were reported here.

Underbelly of the ‘golden state’

Sikkim joined the Indian republic in 1975, and has gradually become the poster child for development and a booming economy. Between 2004-05 and 2011-12, the state witnessed the highest net state domestic product in the country, and was the third richest state in India according to the 2015-16 Economic Survey.

In September 2018, Sikkim got its first airport at Pakyong near Gangtok, and in October, it was awarded by the United Nations for becoming the first state in the world to become 100 per cent organic. Literacy and cleanliness are high, and it’s often referred to as a ‘golden state’.

Yet, it has a sordid underbelly, which is manifesting itself in suicides and the questionable mental health condition of its residents. Regardless of age, gender, rural-urban divide, economic or health status, suicide looms everywhere.

Also read: What the history of foreign invasions tell us about suicides across India

A number of factors

“It would be very difficult, and even unfair, to pinpoint a particular reason for why Sikkimese people are turning suicidal. There are several factors: A long history of alcohol and drug abuse, unemployment, high aspirations, ignorance of mental health illnesses and changing family structures,” said Yumnam Suryajeevan, assistant professor of sociology at the Sikkim Manipal University.

Social worker Dr Satyadeep Chhetri adds three more factors — lack of socialisation, loneliness and high rates of adultery.

“Around 70 per cent of people who have committed suicide were loners — either they were separated couples, aged people living away from their children, or kids from broken families. There is no study to connect suicide with adultery or other factors, but many people have committed suicide due to marital discord,” Chettri said.

A case in point is that of a 12-year-old girl who committed suicide on 26 June 2017 because she longed for parental love.

The seventh grader from Timberbung village in West Sikkim used to live with her old grandparents after her parents drifted apart and started living with their respective lovers, said an investigating officer from Soreng police station.

Drugs and alcohol

Many Sikkimese youth are high on pharmaceutical drugs like Nitrosun 10mg, Spasmo Proxyvon (SP) and cough syrups like Corex and Phensedyl, which are smuggled into the state from the neighbouring Siliguri in West Bengal.

“Drug users are very vulnerable to suicide,” said Prashant Sharma, member of the Sikkim Drug User Forum.

Former drug user Robin Rai recalls trying to kill himself during one of his weak moments nine years ago. Rai, who works as a counsellor at a suicide helpline centre in Gangtok, said he gets numerous calls from drug users with suicidal tendencies.

The state’s climate, geographical location, and the easy availability of alcohol has made it vulnerable to alcohol abuse as well.

Sikkim’s history with alcohol dates back to 1954, when Sikkim Distilleries was set up in Rangpo to ensure quality liquor for its citizens at a reasonable price. The then Chogyal (king) agreed to give the company absolute monopoly for the manufacture of alcohol, on the condition that the government was given 47 per cent of its shares. The state earns considerable revenue every year from alcohol sales — in 2013-14, the figure stood at Rs 120.64 crore.

K.C. Nima, a public health activist, shared the story of Suresh (name changed), a 40-year-old chronic alcoholic who had attempted suicide twice.

“The Sikkim High Court had to order the state to provide rehabilitation for him. There are many such cases,” Nima said.

Charvi Jain, a Kolkata-based psychotherapist, said that dysfunctional families, loneliness and drug and alcohol abuse are all interconnected. “It can be a deadly cocktail for suicide,” she said.

Also read: Suicides high among married women: Crisis in Indian marriages or mental health stigma?


According to a report by the Labour Bureau of the Ministry of Labour & Employment, Sikkim has the second highest unemployment rate in India.

Prawesh Lama, guitarist for the popular local band Tribal Rain, said the rush for government jobs had something to do with it.

“The problem of educated unemployed youth is high here. Sikkimese youth focus only on government jobs. But such jobs are for just a few who have the ‘right’ contacts,” Lama said.

“People are not willing to compete in the private sector. In this struggle to grab a government job, many youth get frustrated-some fall victim to drug and alcohol abuse, while a few even lose the urge to live.”

Cultural stigma of mental illness

Historically, the rulers of Sikkim have had no record of suicidal deaths. However, according to local tribal myth, adultery in a past life could lead to unnatural deaths, said L. Khamdak, professor of Limbu cultural studies at Namchi Government College in South Sikkim.

Tshering Tamang, a shaman based in Pelling, West Sikkim, added: “Every person has a predestined time to live. If someone kills themselves before time, their soul turns into Sian (evil spirit).This Sian can take lives of other people known to him or her in the similar way. More suicides will take place till the spirit completes its life-circle.”

In Sikkimese religious practices, mental health is often misunderstood. People with serious mental health illness approach religious gurus and shamans rather than coming to a doctor, said a psychiatrist based in Geyzing, West Sikkim, who did not wish to be named.

What has the administration done?

Other than an unpublished study conducted by Sikkim University, the state government has done very little research on the issue. ThePrint repeatedly tried to contact state health minister Arjun Ghatani, health secretary Vishal Chauhan and other senior officials, and emailed them questionnaires on the issue. But the only official response was an email from the health department, acknowledging receipt and saying it would take time to reply to the questions, “as this is a government procedure”.

However, that’s not to say there haven’t been efforts to curb suicides. A senior health department officer said on the condition of anonymity that the state was trying its best to combat the growing problem.

“The Sikkim Mental Health programme is operational since 2011, and we are conducting many awareness campaigns across the state,” the officer said.

In 2015, a state-funded 24×7 suicide helpline centre (03592-2021111, 18003453225) equipped with trained counsellors was started from the psychiatric department of the Sir Thodup Namgyal Memorial Hospital in Gangtok. However, the centre has received just 182 genuine calls so far, because hardly anyone seems aware of it. There were no advertisements for this number in Gangtok or West Sikkim, and helpline head Dr Jigmee K. Topgay said the reason was a lack of funding for promotion.

Hardly any local psychiatrists or health department officials were willing to speak on record when contacted for this report, because when a few of them spoke to a national daily on this issue, they were transferred from Gangtok to far-flung regions of the state.

One exception was Dr Satish Rasaily, a psychiatrist who has worked closely in the past with the government on suicide awareness programmes.

“The state has done several suicide prevention campaigns in Gangtok,” he said.

But outside the state capital, the track record of awareness programmes gets a bit murky. On the one hand, health department officials claim they conduct regular camps, as do local government officials like Hemant Limbu, vice-president of the Darap village near Pelling.

“We have a conducted a community level awareness programme where doctors, psychiatrists and suicide counsellors from Gangtok visited our area on the occasion of World Mental Health Day on 10 October 2018,” Limbu said.

But on the other hand, people in many other villages in West Sikkim said such camps were a rarity.

Also read: One in every 3 women who commit suicide globally is an Indian

How to fix this problem

Parul Agarwal, a Siliguri-based counsellor and psychotherapist suggested that the Sikkim government should work on spreading awareness about mental health.

“Forming a team of well-trained counsellors and psychiatrists who can work at the grassroots level can be a good start. Regular workshops, seminars in schools and colleges and a compulsory HR policy on mental health awareness at workplaces can be helpful,” she said.

Among all the religious groups in the state, incidents of suicide are least among the Christian community, and that’s because of a conscious effort that others could emulate, said Father Moni Clement Lepcha of St Mary’s Catholic Church, Geyzing.

“We regularly hold conversation with our parish members. When we talk about our problems, it helps a lot in venting out,” he said.

Social worker Chhetri added: “We have to tap the emotional quotient of Sikkim’s citizens. We have to tackle this situation as a society. We need to be more open to talk to each other, create occasions to meet and socialise.”

The Depression Symptom We Rarely Talk About

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By Emily Blackwood

Anyone who has ever gotten cut off in traffic or stubbed their toe on a coffee table knows how quickly anger can go from zero to 100. Most of the time, getting mad is just a part of being human. But in some cases, constant rage could be a sign of a deeper issue: depression.

A 2014 study found that that anger — both overt and suppressed — is actually a common sign of the mental health condition. Psychologists suggest that people who have difficulties coping with their anger are at risk of developing depression. Experts have even described the mental illness as “self-directed anger” or “anger turned inwards.”

“It doesn’t always look like depression, but it is,” said Marianna Strongin, a licensed clinical psychologist in New York.

Research has shown anger is associated with “greater symptom severity and worse treatment response” when it’s part of a mental health condition like depression. That’s why Strongin encourages anyone who is feeling angrier than usual to reach out for help instead of brushing it off.

“A patient will say they’ve noticed, or their friends have noticed, that they’re lashing out more,” she said. “Although they come in to address their anger, when we start digging, the anger is usually a symptom of depression.”

Rather than feeling sad or empty, like we commonly believe people with depression do, some people more quickly turn to anger. Strongin said that’s because it’s often easier to feel angry than it is to experience more morose emotions.

“Sadness is much harder to experience,” she said. “Sadness is a phase, and anger is a verb ― it moves through you. So sometimes [people with depression] distract themselves to not feel sad, so instead, anger gets triggered.”

According to the National Institute of Mental Health, many of the estimated 16.2 million American adults who live with depression are women ages 18 to 25. But Florida-based psychologist Sherry Benton says it’s typically men who exhibit anger as a symptom.

“Their natural inclination tends to lean toward isolation,” she said. “With this comes the need to withdraw from relationships with others, even ones that are healthy. Anger is a seamless secondary symptom to this, since lashing out is generally an effective method of pushing people away.”

Because men so often push loved ones away and mask their depression entirely, it’s more likely to be deadly. Approximately 17 percent of men will have major depression at least once in their lives, and men are 4 times more likely than women to die by suicide, according to a Harvard Medical School report.

But that doesn’t mean women don’t experience anger as a symptom of depression too. Bess Meade, an art director, designer and writer living in Oregon, was diagnosed with depression when she was 19 and experienced anger as a main symptom. She noticed it was getting out of hand when she snapped at a co-worker during a meeting and broke a window at an ex-boyfriend’s house.

“My mom has commented before that I seem angry, and that I should ‘do something about it,’” said Meade, who is now 29. “I think I had a perception of depression as being a weakness, which I don’t believe at all anymore, but made me hesitant to call a spade a spade when I was younger.”

Meade was able to manage her condition and her anger symptoms through a combination of antidepressants and healthy lifestyle changes.

“I started going to yoga classes while I was really struggling with depression about a year ago, and definitely feel like it has increased my awareness of my body and my breathing, which can sometimes help me get out of a funk,” she said.

“With just anger, it’s never just anger. It’s always symbolic of something not working.”


In addition to medication, breathing practices and exercise, Strongin said journaling can be a beneficial tool in managing anger and getting to the root cause of a patient’s depression. She tells her patients to write down their negative thoughts, then question them and look for evidence that what they’re saying is true.

“If the thought is ‘I’m not good enough,’ I’d ask, ‘How are you not?’” she said. “When you have insecure thoughts, follow them up with answers.”

But no matter what tools you find useful, the first step is getting help. Talking with a mental health professional can help you manage depression and its accompanying symptoms.

“With just anger, it’s never just anger,” Strongin said. “It’s always symbolic of something not working.”

“Living With” is a guide to navigating conditions that affect your mind and body. Each month, HuffPost Life will tackle very real issues that people live with by offering stories, advice and chances to connect with others who understand what it’s like. In February, we’re covering depression. Got an experience you’d like to share? Email wellness@huffpost.com.

If you or someone you know needs help, call 1-800-273-8255 for the National Suicide Prevention Lifeline. You can also text HOME to 741-741 for free, 24-hour support from the Crisis Text Line. Outside of the U.S., please visit the International Association for Suicide Prevention for a database of resources.

8 Things People With High-Functioning Depression Do Differently

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By Hannah Irelan

1. They lose the happiness in the little things. The things that used to grant them their much-needed escape from the world now feel like burdens holding them down. They aren’t brightened by the idea of joy, they are crushed by it, but they work like hell to participate anyway.

2. They can’t accept the idea that sometimes, mistakes happen, and that doesn’t mean they’ve lost their worth. Mistakes can sometimes feel like a death sentence on our dreams for everyone, but for people suffering from high-functioning depression, mistakes can often be the catalyst for crippling self-deprecation.

3. They never think they’ve done good enough. They are in a constant state of self-doubt. They never feel worthy enough, safe enough, of like they’ve done a good enough job.

4. They’re always tired, but they always show up. While their life may always feel like an uphill battle, they always come with a sword in hand, ready to fight.

5. The little struggles we all face start looking like major hurdles. They are unable to distinguish what is dire and truly difficult, to what their depression is morphing into as a major hurdle in their life.

6. They can’t focus on the future because they are still worried about the past. Working hand in hand with self-doubt, people with high-functioning depression are in constant turmoil about if their life is where it should be.

7. They just can’t slow down. People with high-functioning depression have a leniency towards perfection, and often don’t rest until that standard is met. They struggle to accept anything less than this diluted idea, and oftentimes, this is a struggle that follows them through their entire life.

8. They have good days too. They can push through the bad times and see the good in things, too, but that doesn’t mean that they still aren’t battling with the silent demons they are trying so hard to keep covered.

Acknowledge that you hear them. Give them some love. Believe me, they need it most.

What It Means To Be An Introvert With Depression

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By Alyssa Lynn Malmquist

What’s wrong with you? Why aren’t you smiling more? Why aren’t you talking? Why aren’t you having fun? Is everything okay? Did something happen? Why can’t you snap out of it?

These are some of the questions commonly spit at someone who isn’t so visually energized. Although the person may not display outward, they could be enjoying their time even more so than you, even if that’s not the story their face is telling.

Introverts don’t always mesh well in a social environment, and to no one’s surprise, depression doesn’t either. Depression is still unknown to a lucky some, and it can be difficult to talk about while even harder to understand.

Introverts are constantly labeled negatively based on peripheral judgment while internally, they could just be re-charging. Perhaps they’re reflecting or taking in a new environment using energy that runs out at the speed of light.

So, with depression added to the mix, the behavior can be more than off-putting pushing the people closest to you away. Temporarily, this is what the introvert wants, but the opposite of what the depressed person needs. Introverts find solace in isolation as it allows them to charge their batteries and prepare for their next interaction. It’s hardest to feel energized in unfamiliar settings or with people you hardly know. So, when the person is also depressed, it makes it even more difficult to ask for the help they so desperately need. The energy is not there as comfort in seclusion grows. This comfort is masked as something positive, as loneliness trickles in alongside hopelessness and depression.

Being on the receiving end can be tough to comprehend and take on. So, pushing these people away can feel natural even though it’s the opposite of what they need. Asking for help is hard enough for anyone, but with the debilitating duo of depression and the behavior of an introvert, it feels impossible to seek help. Your introverted nature puts you inside a bubble while depression keeps you there. Depression keeps you there while pushing you further inside, to the point where you no longer see a point in breaking out.

If you have a friend that shows these signs, know that help is not simple. You alone can’t help the problem, but you can be a part of the solution. Helping someone with introverted tendencies that are battling depression is complex. What your friend needs most is support. What your friend needs is the help they didn’t ask for. Don’t let them push you away; they need you more than they can communicate.

How Can We Prevent Depression In Young Adults?

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Worldwide over 300 million people are affected by depression: it is one of the most common mental health disorders and a leading cause of disability (WHO, 2018). Depression develops frequently during adolescence, between the ages of 18 to 25 (Eaton et al., 2008), resulting in poorer outcomes for people throughout their lives such as achieving a lower educational level, being unemployed and having other types of mental health problems (Fergusson, Boden, & Horwood, 2007).

Given that the numbers of young adults with depression is increasing (Mojtabai, Olfson, & Han, 2016) and that services to help them are not widely available, preventing people becoming depressed should be a top priority in any country. There are many published papers about what types of interventions work to prevent adolescents becoming depressed, but previous research has found no evidence to support the implementation of depression prevention programmes. A recent open access review by Breedvelt and colleagues from London and Amsterdam sought to summarise, evaluate and review the effects of such prevention interventions by answering the following questions:

  • Are interventions to prevent depression effective at reducing the symptoms of depression or young adults being depressed compared to the control group who received no interventions?
  • Are there any underlying factors, such as the type of intervention used, influencing this effect?

Many research studies have focused on preventing depression in young people, but the evidence remains equivocal.


The researchers searched a number of databases (Cochrane, PubMed, PsycINFO and EMBASE) for studies exploring the prevention of depression in young people. Their review included studies that used any type of therapeutic help, such as cognitive behavioural therapy or mindfulness aimed at preventing depression, but excluded medication. Those taking part in these studies had no previous diagnosis of depression or no symptoms of depression or symptoms that were considered to indicate a diagnosis of depression. The quality of each study was analysed to decide whether the methods used were likely to be effective. The effect of each kind of intervention was worked out by looking at the differences in the changes of depressive symptoms before and after the intervention between the intervention and control groups.

The protocol for this review was registered on PROSPERO as is standard practice. The reviewers performed a random-effects meta-analysis of the randomised controlled studies that compared an intervention for young adults (aged 18-25) without a diagnosis or history of depression and a control condition. Comparisons between intervention and control group outcomes were carried out at the post-intervention time point. They also compared intervention and control group outcomes at later follow-up time points where data were available.


  • This review found that symptoms of depression were reduced in young adults who participated in specific types of interventions compared to those who did not
  • There was no specific type of prevention that was more effective than any other
  • The researchers were not able to conclude whether the interventions successfully prevented the development of depression as none of the studies used a recognised method to measure depression after the intervention
  • Importantly, the majority of the studies analysed in this review were found to be of low quality, due to poor quality research methods used, such as missing outcome data for some participants and selective reporting of findings.

Preventive interventions can be effective at reducing sub-threshold symptoms of depression, but none of the studies in this review assessed the effects of such interventions on onset of depression.


The researchers conclude that it is too early to tell whether the interventions could prevent young adults from becoming depressed. They did, however, consider there is reason to be optimistic as they found some evidence to suggest that interventions could reduce the symptoms of depression in young adults. The finding that no specific type of intervention was more effective than any other suggests that the positive effect of a therapeutic intervention may be common to all types of preventative interventions and not specific to any underlying theory about depression.

Strengths and limitations

Overall, this study was methodologically sound. The authors’ interpretation of the results was reasonable based on the available evidence. Firstly, they registered their study design in an online database before starting. This is an important first step, as it shows that the authors did not change their study hypotheses or statistical analyses based on their results. Secondly, they recognised that the included studies were of a low quality, which weakened their results. Thirdly, they accounted for publication bias. This term refers to how studies are usually not published if they do not find an effect, resulting in most of the research papers available reporting a successful intervention. However, this may not be the true picture. By measuring this bias, the authors took it into account when interpreting their results.

How confident we can be that the findings of such a review represent reality depends on the studies that are included in it. Unfortunately, the available research on this topic has many shortcomings. The researchers had to rely on studies that were of low quality, investigated only university students, only measured depressive symptoms reported by participants rather than diagnosed by a clinician, and failed to report on factors relevant to young people developing depression such as their socio-economic status. Because of these limitations, the researchers are clear that they cannot be confident that their results show a true effect. Additionally, the researchers excluded the majority of the studies they found after their first search: some reasons for this exclusion were not reasonably justified and perhaps could have been unnecessary. For example, nearly half of the final number of studies (11) were excluded because the researchers could not access them. For these reasons, the findings from this review should be re-examined more broadly.

Research needs to include young adults from all backgrounds, not just university settings.

Implications for practice

The current research findings highlight the potential benefit of interventions in reducing depressive symptoms in young adults, giving reasons to be optimistic. However, the review suggests the available evidence base does not enable the researchers to conclude that currently available interventions could reduce the numbers of young people developing depressive symptoms. It emphasises the need for further good quality studies to be undertaken.

To effectively assess the benefits of different interventions, Breedvelt et al. (2018) emphasise that future studies need to provide information on the number of young people becoming depressed before and after the interventions. They also suggest that information about the participants such as their age and socio-economic status should be consistently reported. Furthermore, more studies outside university settings are needed with non-students. Future studies should also report clearly on the participants’ histories of depression and include long-term follow-up of outcomes for these young people.

The current review could not find any significant relationship between the characteristics of the intervention and its effect on reducing the young people’s depressive symptoms. In other words, the effects of the interventions used in these studies seem to be similar. This finding could suggest that the non-specific intervention characteristics, namely the factors that are shared across most interventions (e.g. better awareness of emotional experiences), might play a role in the interventions that prevent depression. However, even though not significant, it is essential to note that some characteristics showed a trend towards being more efficient in reducing symptoms. They are depression prevention focus, targeted prevention, online delivery and “other” (non-mindfulness, CBT or mind-body) interventions. Future studies could investigate the underlying factors that contribute to the preventive effect in order to create more effective interventions.

Current research findings highlight the potential for interventions to be able to prevent major depressive disorders in young adults. These findings may inform the design of future research. 


Thanks to the UCL Mental Health MSc students who wrote this blog: Ivana Hezelyova, Zsofia Dombi, Zsofia Sophansay, Karen Chan, Elnaz Gültekin, Stanislava Stashchenko, Isabelle Goehre, Jasper Ho – @Conscience_Psyc, Clementine Pizzey-Gray – @pizzeygray, and Mariam Riaz.


Primary paper

Breedvelt JJF, Kandola A, Kousoulis AA, Brouwer MW, Karyotaki E, Bockting CLH, Cuijpers P. (2018) What are the effects of preventative interventions on major depressive disorder (MDD) in young adults? A systematic review and meta-analysis of randomized controlled trials. Journal of Affective Disorders, Volume 239, Pages 18-29 https://doi.org/10.1016/j.jad.2018.05.010

Suicide Attempt Survivors Speak: On Trying Again.

New Posts To Come! Preview For Tomorrow’s Post.

Tomorrow’s Snowboarding & Suicide Series will focus on what sort of internal conflicts or just what it is like for different people and their different failed suicide attempts. In this instance, it happens to be mine. I was sort of blasé about then situation (hence the featured image). I do not want my own experiences, perceptions, and general emotional opinion on the situation to overshadow those of other.

There is no black & white when it comes to depression & suicide. These things can appear different to everyone. Before publishing my own take on what it is like to have survived a suicide attempt, I wanted to share some resources that provide different points of view around the situation & some extra resources.

No one’s experience is “right” or “wrong” when it comes to any aspect of mental illness. This is no exception.

41 Secrets Of Suicide Attempt Survivors

7 Things I Learned After My Failed Suicide Attempt

After A Suicide Attempt, The Risk Of Another Try
*This one is pretty important, about 2 weeks after the first attempt. I was extremely close to trying again. Dangerously close. Don’t make the mistake I almost did.



TedTalks About Overcoming Depression

“”The opposite of depression is not happiness, but vitality, and it was vitality that seemed to seep away from me in that moment.” In a talk equal parts eloquent and devastating, writer Andrew Solomon takes you to the darkest corners of his mind during the years he battled depression. That led him to an eye-opening journey across the world to interview others with depression — only to discover that, to his surprise, the more he talked, the more people wanted to tell their own stories.”
“Having feelings isn’t a sign of weakness — they mean we’re human, says producer and activist Nikki Webber Allen. Even after being diagnosed with anxiety and depression, Webber Allen felt too ashamed to tell anybody, keeping her condition a secret until a family tragedy revealed how others close to her were also suffering. In this important talk about mental health, she speaks openly about her struggle — and why communities of color must undo the stigma that misreads depression as a weakness and keeps sufferers from getting help.”